Phoenix Service Corporation

LBN: Phoenix Service Corporation
Phoenix Service Corporation is an health care organization with primary practice located at 330 Marie Ave E , West St Paul MN 55118-4011. The organization recently has 4 registered licenses in different health care specialties including Agencies / Case Management, Agencies / Nursing Care, Agencies / Community/Behavioral Health, Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities. Agencies / Case Management is the primary health care specialty. Phoenix Service Corporation can be contacted via phone (651) 227-7655, or through Scott, Darlene M via phone (651) 227-7655.

Contact Information

Primary practice address
330 Marie Ave E West St Paul MN 55118-4011
Phone: (651) 227-7655
Fax: (651) 227-6847
Website:
Map and Directions
Authorized official contact:
Name: Scott, Darlene M
Phone: (651) 227-7655

Health care specialties

SpecialtyCodeLicense #State
Agencies / Case Management 251B00000X 1069741-1-HCBS Minnesota
Agencies / Nursing Care 251J00000X Minnesota
Agencies / Community/Behavioral Health 251S00000X 1069741-1-HCBS Minnesota
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320900000X 1014199-1-WS Minnesota

Profile Details

NPI number 1881645067
LBN Legal business name Phoenix Service Corporation
DBA Doing business as
Authorized official Scott, Darlene M
Entity Organization
Organization subpart 1 No
Enumeration date May 13th, 2006
Last updated Jul 17th, 2014 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881645067 NPPES
Minnesota MEDICAID 596555100

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